Music in Dementia Care

The journal article “Indirect Music Therapy Practice and Skill-sharing in Dementia Care” was published in the Journal of Music Therapy in the Fall 2018 issue. This was not a research article but rather a discussion of ways the various music therapists had collaborated with family members and care-giving professionals who work with people with dementia. The authors hope to develop a protocol for “skill-sharing” in order to make it safer and more effective for the caregivers and those they care for. Many caregivers may not have enough knowledge or experience with dementia or be familiar with safe and effective music techniques. One of the issues raised in the discussion was the clinical decision between “direct music therapy”, that is when the music therapist works with the client, and “indirect therapy”, that is when the music is provided by family members or professional caregiving staff. Direct music therapy is most appropriate when the clients is experiencing severe behavioral or psychological symptoms. However, there are many times during the routine cares of the day when a music therapist would not be present, such as bathing or getting dressed. This is when it would be beneficial for the caregiver to have some training in musical techniques to help reduce agitation. Teaching the caregiver some skills may also be part of the termination process when direct care is no longer expressly needed. In some cases, the music therapist may provide direct care to the caregiver in helping them adjust to their new role. In helping the caregiver develop their own coping strategies, the music therapist may in fact be providing in-direct care to the person with dementia. Basic music training was identified as a need for health care staff and family caregivers. The authors acknowledged the heavy load of music therapists providing direct care. Some therapists may find it challenging to train others as well as fulfill the needs of their own caseload. In addition, many caregivers face their own time constraints making it difficult to attend a training or learn new skills. I have seen that many people desire to use their musical skills to help others. I would like to see a general protocol for how to help musical volunteers and caregivers be safer and more effective.